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Work From Home Claim Adjudication Jobs (NOW HIRING)

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

Work from Home

Boise, ID · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

Work from Home

Tucson, AZ · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

Work from Home

Ogden, UT · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

Work from Home

Denver, CO · Remote

$18/hr

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...

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Work From Home Claim Adjudication information

See salary details

$15

$36

$46

How much do work from home claim adjudication jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for work from home claim adjudication in the United States is $36.99, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $42.79 per hour, depending on experience, location, and employer.

What is a work from home claim adjudication job?

Work From Home Claim Adjudication jobs involve reviewing and processing insurance claims remotely. Claim adjudicators examine claims to determine their validity and ensure they comply with policy guidelines and regulations. These professionals work for insurance companies or third-party administrators, using specialized software to analyze documents, communicate with clients, and authorize payments or denials. Working from home provides flexibility while still requiring strong attention to detail, confidentiality, and knowledge of insurance policies.

What are the key skills and qualifications needed to thrive as a work from home claim adjudicator?

To thrive as a Work From Home Claim Adjudicator, you need strong analytical skills, attention to detail, and a solid understanding of insurance policies or healthcare claims, often supported by relevant experience or certification. Familiarity with claims management systems, electronic documentation tools, and sometimes industry certifications like AIC or CPC are typically required. Excellent written communication, time management, and self-motivation are vital soft skills for remote work efficiency and collaboration. These skills and qualities are crucial for ensuring accurate claim processing, minimizing errors, and maintaining compliance in a virtual work environment.

What are some common challenges faced by remote claim adjudicators, and how can they be addressed?

Remote claim adjudicators often face challenges such as staying organized with high volumes of claims, maintaining effective communication with team members, and ensuring data security while working from home. To address these, it’s important to establish a structured daily routine, make use of secure company-provided systems, and participate in regular virtual meetings to stay connected with colleagues. Leveraging collaboration tools and adhering to best practices for data privacy can also help ensure accuracy and compliance in your work.

What is the difference between Work From Home Claim Adjudication vs Work From Home Claims Processor?

AspectWork From Home Claim AdjudicationWork From Home Claims Processor
CredentialsInsurance or healthcare certifications, relevant licensesBasic insurance knowledge, customer service skills
Work EnvironmentHome office, computer-based tasks, detailed reviewHome office, data entry, customer interaction
Industry UsageInsurance companies, healthcare providersInsurance companies, third-party administrators
Job FocusAssessing and approving insurance claims based on policiesProcessing claims, data entry, customer support

Work From Home Claim Adjudication involves evaluating insurance claims to determine approval based on policies and regulations, requiring specialized knowledge and certifications. In contrast, Work From Home Claims Processors handle the data entry and customer interactions related to claims, focusing on processing and documentation. Both roles are essential in the insurance industry but differ in responsibilities and required credentials.

More about Work From Home Claim Adjudication jobs

What cities are hiring for Work From Home Claim Adjudication jobs?

Cities with the most Work From Home Claim Adjudication job openings:

What states have the most Work From Home Claim Adjudication jobs?

States with the most job openings for Work From Home Claim Adjudication jobs include:

Infographic showing various Work From Home Claim Adjudication job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $76,935 per year, or $37 per hour.

Work from Home

IQVIA

Grand Junction, CO • Remote

$18/hr

Full-time

Posted 8 days ago


IQVIA rating

8.1

Company rating: 8.1 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

62nd of 224 rated it services


Job description

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Pharmacy Support Call Center Representative is primarily responsible for fielding requests such as: card activation, program eligibility, explanation of program benefit and explanation/troubleshooting of submission rejection.

Role Purpose:

  • Primary Call Center contact for patients, pharmacies and medical professionals utilizing an Opus Health program. Call Center Representatives are responsible for fielding requests such as: card activation, program eligibility, explanation of program benefit and explanation/troubleshooting of submission rejection.

Job Responsibilities:

  • Provide initial support for customer requests via telephone, email, fax, or other available means of contact to the Support Center
  • Quickly assess the user's issue and provides first level support for problem resolution
  • Document information specific to the resolution and escalate unresolved issues expeditiously to the appropriate area
  • Recognize operational challenges and suggest recommendations to management, as necessary
  • Ability to work 40 hours per week (shifts available: 8:00 am - 5:00 pm EST or, 9:00 am - 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST - 8:00pm EST) under moderate supervision

Minimum Education & Experience:

  • High School Diploma or equivalent
  • Pharmacy Technician experience required
  • HIPAA certified
  • Call center experience required (3+ years preferred)
  • Experience in medical claim processing is a plus
  • Bi-lingual (English/Spanish) is a plus

The pay range for this role is $18.00 per hour.

IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

#LI-CES

#LI-Remote

#LI-DNP

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $18.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.

What IQVIA employees say

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Benefits

Hours and flexibility

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About IQVIA

Sourced by ZipRecruiter

At IQVIA, we are passionate about helping customers and partners improve results and patient outcomes. Everything we do contributes to this vision for creating a healthier world. In today’s healthcare environment, it’s not only about how much data, information, and technology you have at your fingertips – it’s what you do with it. IQVIA is focused on making intelligent connections for customers across the entire healthcare ecosystem to help you drive healthcare forward. Whether that means partnering with novel technology companies to boost patient engagement, leveraging AI & machine learning to accelerate results, or using decentralized trials to reach the right patients wherever they are – we are always looking for smarter ways to move you forward.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Durham, NC, US